Role of Sympathetic Activity in Blood Pressure Reduction With Low Calorie Regimen

To investigate the effects of a low calorie regimen on sympathetic function and its relation to blood pressure response, 22 untreated obese essential hypertensive patients (50±2 years, body mass index 29 ±1 kg/m2) were hospitalized and a diet was prescribed of 2,000 kcal/day for 5 days (control period) followed by 800 kcal/day for 21 days without changing salt intake (8-10 g/day). The dose of intravenous phenylephrine infusion needed to elevate systolic blood pressure 20 mm Hg (CD20) and the 24-hour urinary excretion of norepinephrine (UNE) were measured. During the low calorie period, blood pressure normalized in 14 patients (responder group, 124±3/79±4 mm Hg) and eight remained hypertensive (poor responder group, 158±6/103±3 mm Hg). At the control period, blood pressure and body mass index were similar, but the responder group had higher UNE (134±15 μ/day) and CD20 (127±11 μg) than the poor responder group (89±6 μ/day and 79±13 μ, respectively). During the low calorie period, both UNE (87±15 μg/day) and CD20 (74±10 μ) decreased in the responder group; no change was seen in the poor responder group. Changes in UNE and systolic blood pressure were correlated (r=0.6, p<0.05). In conclusion, suppression of sympathetic activity plays a role in blood pressure reduction during moderate caloric restriction.

[1]  R. Giorgino,et al.  Changes in overall plasma norepinephrine turnover and lymphomonocyte beta-adrenoceptor number during combined caloric and sodium restriction in normotensive obese subjects. , 1990, International journal of obesity.

[2]  J. Hall,et al.  Chronic hyperinsulinemia and blood pressure. Interaction with catecholamines? , 1990, Hypertension.

[3]  V. Katch,et al.  The effect of weight loss on the sensitivity of blood pressure to sodium in obese adolescents. , 1989, The New England journal of medicine.

[4]  A. Weder,et al.  Regional hemodynamic abnormalities in overweight men. Focus on alpha-adrenergic vascular responses. , 1989, American journal of hypertension.

[5]  J. Strubbe Central nervous system and insulin secretion. , 1989, The Netherlands journal of medicine.

[6]  T. Ikeda,et al.  Effects of Insulin on Vasoconstrictive Responses to Norepinephrine and Angiotensin II in Rabbit Femoral Artery and Vein , 1988, Diabetes.

[7]  J. Cutler,et al.  The 1988 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. , 1988, Archives of internal medicine.

[8]  B. Fagerberg,et al.  Reactivity to norepinephrine and effect of sodium on blood pressure during weight loss. , 1985, Hypertension.

[9]  B. Fagerberg,et al.  Importance of dietary salt in the hemodynamic adjustment to weight reduction in obese hypertensive men. , 1984, Hypertension.

[10]  B. Levin,et al.  Altered sympathetic activity during development of diet-induced obesity in rat. , 1983, The American journal of physiology.

[11]  J. Sowers,et al.  Reductions in plasma catecholamines and blood pressure during weight loss in obese subjects. , 1983, Acta endocrinologica.

[12]  J. Sowers,et al.  Role of the sympathetic nervous system in blood pressure maintenance in obesity. , 1982, The Journal of clinical endocrinology and metabolism.

[13]  L. Landsberg,et al.  Diet-induced changes in sympathetic nervous system activity: possible implications for obesity and hypertension. , 1982, Journal of chronic diseases.

[14]  J W Rowe,et al.  Effect of Insulin and Glucose Infusions on Sympathetic Nervous System Activity in Normal Man , 1981, Diabetes.

[15]  J. Stamler,et al.  Weight and blood pressure. Findings in hypertension screening of 1 million Americans. , 1978, JAMA.

[16]  R. DeFronzo,et al.  The effects of glucose and insulin on renal electrolyte transport. , 1976, The Journal of clinical investigation.